Hydrocodone and Alcohol

Table of Contents


It is potentially dangerous to combine alcohol and hydrocodone or any other strong prescription medication.

Hydrocodone, like morphine and other opioids, can trigger the development of tolerance, dependence, and addiction in addition to many adverse side effects.

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Alcohol can also induce severe side effects in isolation. When combined with prescription medications like hydrocodone, the side effects of those substances are intensified in often unpredictable and hazardous ways.

In order to explore the perils of mixing hydrocodone and alcohol, we’ll first highlight the negative outcomes brought on by each substance in turn.

Adverse Effects of Alcohol

These are the most common symptoms associated with alcohol intoxication: 

  • Confusion
  • Slurred speech
  • Double vision
  • Loss of physical coordination
  • Impaired judgment
  • Dizziness
  • Sleepiness
  • Mood swings
  • Irregular heartbeat
  • Depressed breathing

If you consume so much alcohol that your BAC (blood alcohol concentration) reaches 0.08% or above, this can lead to the presentation of symptoms such as: 

  • Disrupted sleep patterns
  • Altered emotions
  • Severe mood swings
  • Impaired vision
  • Fatigue and sleepiness
  • Increased production of urine
  • Flushed skin
  • Low body temperature

Alcohol poisoning, also known as alcohol overdose, can occur if you consume very large quantities of alcohol. Symptoms include:  

  • Vomiting
  • Breathing problems
  • Irregular breathing
  • Stopped breathing
  • Changes to heart rate
  • Passing out
  • Choking on vomit
  • Seizures
  • Coma

The sustained abuse of alcohol is damaging to most parts of the body, but especially to the: 

  • Cardiovascular system
  • Digestive system
  • Brain
  • Liver

Abusing alcohol can lead to tolerance, physical dependence, and addiction in the form of alcohol use disorder (alcoholism). Tolerance causes the effects of alcohol to diminish and prompts many people to consume more alcohol to counter this. This abusive pattern of consumption will accelerate physical dependence on alcohol. By this stage, you require alcohol to function normally and experience intensely uncomfortable withdrawal symptoms in its absence. Both tolerance and withdrawal are diagnostic criteria for alcohol use disorder, according to DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders). 

Adverse Effects of Hydrocodone

If you take opioid painkillers like hydrocodone as prescribed for pain relief, you should experience few symptoms of intoxication. It is likely that the following side effects will present, though: 

  • Sleepiness
  • Fatigue
  • Constipation

If the medication is taken in higher doses than prescribed, the following symptoms of opioid intoxication may manifest: 

  • Confusion
  • Delirium
  • Drowsiness
  • Inability to stay awake
  • Nausea
  • Vomiting
  • Depressed breathing

Taking too much hydrocodone can cause an opioid overdose. Hydrocodone overdose can be life-threatening if untreated. Immediate medical intervention and the administration of the opioid antagonist naloxone can reverse the effects of opioid overdose. 

Chronic opioid abuse causes tolerance to form quickly. Dependence and hydrocodone addiction happen often but do not always follow. 

What happens if you mix hydrocodone and alcohol, then? 

An image of a man feeling the effects of mixing hydrocodone and alcohol

Effects of Mixing Hydrocodone and Alcohol

If you are prescribed hydrocodone or any other opioid-based painkiller, you should not drink alcohol while taking the medication. The side effects of combining these substances can be dangerous and possibly deadly. 

Alcohol and hydrocodone are both depressants of the CNS (central nervous system). As such, both substances lead to: 

  • Relaxation
  • Pleasurable feelings
  • Altered breathing and heart rate
  • Reduced clarity of thought
  • Memory loss

The most dangerous of these side effects are those involving heart rate and breathing. When two different drugs cause these side effects, mixing the substances will increase the risk of: 

  • Unconsciousness
  • Stopped breathing
  • Heart failure
  • Death

CDC (Centers for Disease Control and Prevention) report that alcohol abuse is prevalent among those who abuse prescription drugs. A CDC analysis found that alcohol was implicated in almost one in five ER admissions involving opioids. Alcohol was also associated with 22% of fatal opioid overdoses. 

Naloxone is a medication that emergency responders and caregivers can administer to counter the effects of opioid overdose. Naloxone becomes less effective if opioids are combined with alcohol. 

The risk of a deadly overdose is substantially increased when two CNS depressants like alcohol and hydrocodone are combined. 

Using hydrocodone and alcohol in combination also increases the likelihood of: 

  • Loss of consciousness
  • Vomiting
  • Alcohol poisoning (alcohol overdose)
  • Weak heart rate
  • Dangerously slow breathing
  • Seizures
  • Coma
  • Death

Additionally, the concurrent use of hydrocodone and alcohol can adversely affect the liver.

Alcohol damages the liver over time. Mixing alcohol with hydrocodone combination products like Vicodin that contain acetaminophen lowers the liver toxicity threshold for acetaminophen. This can lead to liver damage and acute liver failure.

The other significant danger of polysubstance abuse involving hydrocodone and alcohol is the development of addictions to one or both substances. 

Addiction to Hydrocodone and Alcohol

Combining alcohol and an opioid like hydrocodone can intensify and compound the effects of each substance, both short-term and long-term. The greatest of these risks is hastening the development of tolerance and dependence, potentially bringing about a polysubstance addiction. 

Some people combine alcohol and hydrocodone in an attempt to increases the euphoric effects delivered by each substance. The brain rapidly craves more of these pleasurable feelings, leading to tolerance forming. By this point, you will need more of the substance or more frequent doses to achieve the initial high. 

As physical dependence develops, you will require alcohol and opioids to function normally. When the effects of the substances wear off, you will experience uncomfortable withdrawal symptoms.

Addiction to alcohol and opioids warrants evidence-based treatment at an inpatient or outpatient rehab center. 

Combined withdrawal from alcohol and hydrocodone can be challenging, dangerous, and possibly life-threatening. Detoxing at home is inadvisable with combined withdrawal symptoms including:

  • Aches and pains
  • Nausea
  • Vomiting
  • Agitation
  • Confusion
  • Restlessness
  • Sweating
  • Goose bumps
  • Increased anxiety
  • Insomnia
  • Hallucinations
  • Seizures

Most people will require a supervised medical detox to withdraw from hydrocodone as safely and comfortably as possible. A clinical detox will also minimize the risk of relapse during detox, a scenario that can trigger a lethal overdose due to diminished tolerance for alcohol and opioids after a period of abstinence.

view from california detox 30 day inpatient rehab

Hydrocodone and Alcohol Addiction Treatment at California Detox

If you are addicted to alcohol and a prescription opioid like hydrocodone, the safest and most effective route to recovery involves a supervised medical detox followed by inpatient or outpatient therapy. We can help you achieve this at California Detox in Orange County. 

We provide treatment programs at all levels on American Society of Addiction Medicine’s continuum of care as follows: 

  • Outpatient programs
  • Intensive outpatient programs
  • Partial hospitalization programs
  • Inpatient programs (residential rehab)
  • Dual diagnosis (addiction with co-occurring mental health disorder)
  • Supervised medical detoxification

Detoxing from hydrocodone and alcohol typically takes one week. Your treatment team will administer medications to mitigate cravings and withdrawal symptoms. After seven to ten days, your system will be substance-free, and you can transition into one of the above treatment programs. 

All alcohol and opioid addiction treatment programs at California Detox draw from the following pharmacological treatments and behavioral therapies: 

  • MAT (medication-assisted treatment)
  • Individual counseling
  • Group therapy
  • Family therapy
  • Psychotherapies (talk therapies like CBT and DBT)
  • Holistic therapies

When you are ready to reclaim your life from hydrocodone and alcohol addiction, reach out to admissions by calling 949.390.5377.


No. Mixing these CNS (central nervous system) depressants increases the risk of adverse side effects, overdose, and addiction. It is unsafe to mix hydrocodone and alcohol.
Yes. Combining these substances increases the risk of both hydrocodone overdose and alcohol overdose (alcohol poisoning). Both of these conditions can kill you.


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